TiECON SE 2013 Awards - Deal of the Year

"Deal of the Year" Nomination Form

Companies must be located as a primary place of business in Georgia, Florida, South Carolina or North Carolina. All companies and products are eligible for consideration based on their business accomplishments made during calendar 2012. Companies may be nominated for multiple award categories, and companies may win multiple awards. There are no fees to nominate companies for consideration. TiE Membership/Sponsorship is not a criterion for selection.

Candidates for the Deal of the Year award must meet the following specific criteria:
- Merger-Acquisition-IPO should have been executed in 2012.
- Public:Large Corporate Deals will not be considered.
- Financial Criteria should be publicly available, and is not the only criteria for consideration.

- The deadline for all nominations is April 10, 2013
- Attendance at the conference is encouraged. The awards portion of the TiECON Southeast 2013 Conference will be held from 4:00 p.m. - 6:00 p.m. at the Renaissance Atlanta Waverly Hotel.
- All information will remain confidential to the judging team. If you have any questions, please contact admin@tie-atlanta.org.

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* Nominee information

Name:

Company:

Title:

Email Address:

Phone Number:

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* Nominee's Assistant (if applicable)

Name:

Email Address:

Phone Number:

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* Nominator information (if different than nominee)

Name:

Company:

Title:

Phone Number:

E-mail Address:

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* Nominator affiliation with the Nominee:

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* DESCRIBE YOUR COMPANY/VENTURE (Up to 150 words)

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* DESCRIBE YOUR ROLE AND RESPONSIBILITIES IN THE COMPANY (Up to 150 words)

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* PLEASE SHARE YOUR SIGNIFICANT MILESTONES (Up to 200 words)

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* HOW HAVE YOU CONTRIBUTED TO THE COMMUNITY? (Up to 200 words)

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* LIST ANY ADDITIONAL INFORMATION WE SHOULD BE AWARE OF - INNOVATION, SPECIAL CIRCUMSTANCES, UNIQUE CHALLENGES, ETC. (Up to 200 words)

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* What year did you start the company and when did you exit?

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* How many employees did you have at the time of exit?

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* Describe how your exit came together.

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* Name and industry of company that purchased your company?

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* DESCRIBE VALUATION "TIMES" - INVESTED AMOUNT TIMES AMOUNT AT THE TIME OF EXIT/SALE

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* I CERTIFY THAT ALL INFORMATION IS CORRECT.

Yes